Rachel Taulbee:  Keeping the Goal in Sight
Written by Rachel Taulbee
On April 15th, 2017, I was riding my motorcycle. I assume I was riding as winter was just over, and the weather that day was nice. I say assume as that entire fateful day and three weeks following that day have been erased from my memory due to a traumatic brain injury. The following I have gleaned from the police report, articles in the local newspaper and a conversation with the responding state highway patrol officer:  I was hit by a distracted driver who failed to negotiate a curve, drove left of center and struck my motorcycle. I was severely injured, rendered unconscious and was life flighted to OSU Wexner Medical Center where I remained for three weeks, nine days of which were in intensive care. I had several broken bones including my left clavicle, right humerus, left femur and shattered left tibia/fibula. Additionally, I had a traumatic brain injury and was in a chemically induced coma for a few days as the pain from the injuries was intense. I was on both a breathing machine and feeding tubes.  The doctors tried to repair my left lower leg injuries, but they had to proceed with a below the knee amputation as blood flow ceased the day following the intensive surgery.  All other injuries were repaired after four surgeries and intensive care.
I was released after three weeks at OSU to the Logan Care and Rehabilitation Center in Logan, Ohio where I proceeded to spend a month there recovering and going through in-patient rehabilitation. My twin sister has worked there for about fifteen years as an LPN, and she was there daily (working obviously). However, she spent so much of her time at work caring for me, that I was very struck by how kind and thoughtful the administrators of the facility were to allow her to care for me outside of her normal job duties. She accompanied me to doctor appointments, prosthetic appointments, assisted me with showering, and did various small tasks for me. I truly believe her being there and being so caring/supportive quickened my recovery and kept my spirits up. My sister kept friends and family updated on Facebook throughout the three weeks I wasn't mentally able to provide updates/correspond with people. The local newspaper ran a couple articles. I, post-accident, have read the posts and learned quite a bit about the recovery that I don't remember. The most striking thing was the massive amount of concern and support that poured in from friends, family and acquaintances through the Facebook post comments. Just reading those comments during my rough days in recovery has been enormously cheering and provided needed support. I would also randomly run into people I don't know, who I've never met, who may know who I am through so-and-so or from the newspaper articles that tell me I've been in their prayers and they wish the best for me. That kindness and thoughtfulness brings tears to my eyes.
As I previously said, I don't remember the day of the accident or three weeks following the accident. It was difficult for me when I became aware of what occurred because the last I remembered I had a leg, and, then, I did not have a lower left leg. Additionally, I had multiple other painful injuries in the healing process. I've been told by several doctors the only reason I'm still alive is because I was wearing my helmet. That's been a bit humbling as I feel blessed I'm still here to see my daughter grow up, no matter what the state of my physical body may be. My advice for folks going through a long-term healthcare journey in and out of healthcare facilities - take it slow and keep the main goal in mind - RECOVERY! The purpose of all actions and treatments is recovery and good health. I wanted to be back to my pre-accident life and recover ASAP, and that caused me needless grief and anguish. The goal is recovery and good health, no matter the length of time it takes to accomplish those goals. Pushing as hard as possible to walk or recover could cause injuries and grief. I had to take some deep breaths, slow down and those actions bettered my mindset and recovery process. Also, I discovered I wanted things done as I would do/perform them, whether it was the mowing of my yard, my professional job or the household chores. I've had to slow down and focus on the fact that HOW things are being done isn't what's important but the fact that someone has taken the time to do those tasks for me.
We've survived the hardest part of the journey whether it was a serious traumatic injury, the amputation surgery or illness/disease. Now we need focus on recovery and good health which IS possible again. Despite the accident, injury or recovery process, focus on your goals for recovery and the future. Life's hard and the unexpected can happen. I never expected to be hit while riding my motorcycle.  But life continues and can be good. Great even! Focus on the future. I'm here to watch my daughter grow up and have strong hopes to have the same quality and type of life I had before. There's not a lot that can hold me back at this point. I am blessed that I have the support and ability to move forward as I've had and I'm appreciative of it. I focus on my goals of having the same quality of life I had before. AND by remembering that I'm here to watch my daughter grow up and I'm here to be a good mother for her, to love her, and give her a good life.
There have definitely been hard days. I have spent that time looking through all the cards that were sent to me, reading the supportive comments online and spending time with friends and family. I also know that my family has been through so much with this accident and seeing me in terrible health. I want to be positive to show them that I'm improving and can be happy again. I want to alleviate their concern, especially my parents and sister who have been through so much because of the accident.

Rachel Taulbee with Megan Albury, CPO
Megan Albury, CPO (left) with Rachel Taulbee

Being able to walk again [using my prosthesis] is a HUGE step forward toward getting back to my life of being the mother I want to be, the supervisor I want to be at my professional job, a jogger, and ME again. I'm 34 and do not want this accident to change the goals I have for myself or the overall quality of my life. It's completely possible to lead a wonderful life in a wheelchair or without walking, BUT I wanted to be the mother, supervisor and jogger that I was before. My professional job has a component of field work, and I want to be able to fulfill that portion of my job. I feel I'm well on my path toward those goals and have high hopes for the future.
When life was the roughest, the calm demeanor and encouragement shown to me by Megan and Tim kept me encouraged that I could reach my goals of leading the life I always envisioned for myself. Megan was a saint dealing with my pretty common emails as "mini crises" (joking tone) occurred to me. It's a life changer [going through amputation surgery], there's no way around that fact, BUT it may be the best decision for your health or, as in my case, necessary to ensure life continues.  But life does continue after the amputation procedure. You most likely will walk again. You can enjoy life, family and friends. Focus on the future and your goals for life. 

Major Cody: Never Giving Up 

Major Cody had fallen on hard times in the winter of 2016.  He had lost his apartment and was staying with family and friends.  One February night his friend let him sleep in the back of a moving truck that was parked outside. During the next week Major's feet began to burn and swell.  Major tried soaking his feet in warm water and wrapping them up to help with the swelling, but things had gotten so severe that he could not walk.  Major was not able to get shoes on his swollen and sore feet and he was only able to get around by using crutches.  Over the next couple of weeks Major's feet would get a little better and then they would get a little worse.  Finally the pain was too much to bear and he called 911.  After spending quite a few hours in the emergency room, soaking his feet in warm solutions, the emergency room physician admitted Major to the hospital.  In the first two weeks Major was in the hospital his feet turned black and became hard to the touch.  After spending an entire month in the hospital Major was moved to a Skilled Nursing Facility, all the while his doctors were trying to save his feet.  For six months the doctors exhausted every effort to save Major's feet, so he was optimistic that at some point things would turn around.  

In August of 2016, Major's doctors finally made the decision that amputating both feet below the knee was the only course of action left to take.  Major's optimism was dashed and he had a very difficult time accepting the news.  Once the amputation surgery was complete he was told he would be discharged the next day. He remembers being extremely upset as his pain was so great and the bleeding was so heavy.  He ended up having complications that kept him in the hospital for a week and then he was on his way back to the nursing home.  Major had a very difficult time trying to process the loss of his legs.  He was suicidal at first and spent every waking moment thinking about how he could possibly live with no legs.  He began to see a psychologist once a week. Between his visits with the psychologist and his family and friends he felt so much encouragement and he began praying.  It took several weeks, but towards the end of September things started to look up.  

Major says that the biggest challenge for him was accepting the loss of his legs and learning to go on without them.  Since beginning physical therapy with his prostheses, Major says the challenge has shifted.  Now it is more about relearning balance and endurance.  The whole process from beginning to end has been tough, but Major says "being strong, never giving up, praying, having people to talk to and taking the help that was offered to him" are the keys that brought him to where he is today. 

In August of 2017, slightly one year after his amputations, Major will begin looking for his own place and will begin the process of leaving the nursing home!  He is looking forward to getting back to his life.  He is also very thankful for those who have helped along the way.  Major feels so fortunate to have worked with all of his therapists at the nursing home; Amanda, PJ, Kay, Tasha, Morgan and Todd.  He "gives them all an A+ for the care and training they have given."  He is also very happy to have been referred to Optimus Prosthetics.  Major is so glad he is working with Travis - Travis was and is a huge help and is his "numero uno" when it comes to prosthetic care!

Employee Spotlight: David Frautschi
David Frautschi

Ever since David saw the Six Million Dollar Man when he was 6 years old he has been interested in prosthetics.  David started out his education at Wright State University working towards his Bachelors Degree in Biomedical Engineering.  He would wind up getting a degree in Fine Art (drawing, painting, sculpture).  Over the years, David has had various jobs such as a Substitute Teacher, Security Guard, Receiving Dock Clerk, Video Assistant, Student Loan Collector, Shoe Salesman, and Firefighter/EMT.  "I wasn't aware of the existence of the clinical field of a Prosthetics Practitioner until 10 years after graduating from college.  One day, when I was working as a Firefighter/EMT, I decided to google Prosthetics Jobs and this field was the first thing to come up!  I shadowed other practitioners in the field before beginning school again.It felt like a natural fit! Now I am finally able to use my hand skills and creativity to help another person in a very direct manner.  Four years after being certified, this job still feels like a natural fit for me." 

Some helpful advice David would recommend to a new amputee, " Wearing a prosthesis is definitely going to feel different.  Don't sweat it, though, for you can certainly make this happen.  You WILL walk again.... And don't forget to bring some SOCKS!!"

David became certified in 2013. " It's never mundane!  Each patient presents with their own unique clinical problem to solve.  I might get tired, even worn out, but I never get bored!  And it never hurts to be a direct help to someone using your special skill set." 

What David enjoys about Optimus is that "Optimus allows me to spend the time I need with a patient.  They never try to rush me to get the job out the door to make a monthly budget goal.  They always make the patient come first!" 

Physical  Therapy Quick Tips
Activities for Prosthetic Training
The goal of "Quick Tips" is to provide helpful information and be a resource for those individuals helping patients fit with prosthesis learn to use them correctly in order to enjoy a better quality of life as an amputee.
In the last issue, I mentioned the need to educate the patient on a proper HEP (Home Exercise Program) and contracture prevention, as well as the importance of residual limb hip extension. When I lecture to students I always say, "If you get absolutely nothing done with your amputee patient except educating them on the importance of contracture prevention and they are able to demonstrate it with good follow through, congratulations on a job well done! You have set this patient up for success!"
Think about it: if we have full ROM (Range Of Motion) we can always gain strength, but when we lose ROM with a contracture, the patient's potential will be negatively impacted. Strength is not going to do the patient much good if their ROM is limited by a contracture.
So, the next question may be what is a contracture? A joint contracture is when the muscle or muscles of a joint have been permanently shortened restricting the normal movement of that particular joint.
In my opinion, one element of success for patients is pre-prosthetic preparation, and one of the most important things is the prevention of contractures. Any patient that presents with a hip flexor contracture will be compromised, and any joint contracture will limit their potential of normalized gait. Therefore, we need to help patients strengthen the extensor muscles and stretch the flexor muscles. 
I am not a big fan of a patient performing a supine SLR, (supine means lying on your back, and SLR is a straight leg raise) as it does not strengthen their residual limb in the way they will use it with their prosthesis, and may increase the chance of a contracture. If this type of exercise is to be performed, I would coach the patient in the following way:
Supine Hip Extension
The patient is to lie supine and place a large towel roll or a rolled up blanket under the residual limb.  They are to push the residual limb down into the towel roll while they straighten their thigh at the hip. If it is possible, lift the buttocks up off the surface. Cue the patient not to compensate for hip weakness by over recruiting the back.  
Hold for 2-5 seconds. Repeat 5-15 times. Do 1-3 sets.

The Supine Hip Extension helps to strengthen the extensors, but we also want to hit our goal of stretching the flexors. The Supine Hip Flexor Stretch is an easy way to gain some elasticity in the hip flexors.
Supine Hip Flexor Stretch
The patient is to lie supine and pull the sound limb knee toward the chest while they keep the residual leg and pelvis flat on the surface.
  • If they are unable to grab the sound leg, try a towel behind the sound limb.
  • You may also place a weight on the residual limb to help stretch.  
  • You may also educate a significant other to assist with the stretch.
Hold 15-30 seconds.Repeat 5-15 times. Do 1-3 sets.

Andrea Kinsinger, PT
Andrea Kinsinger  has been a licensed Physical Therapist  since 1986.  Andrea has worked with lower extremity amputee patients throughout her career. She enjoys offering her expertise, advice, and support throughout the patient's rehabilitation. Feel free to contact Andrea if she can assist you in any way at: [email protected].

In This Issue
Cincinnati Courses:

Course # 4
08/02  12:00 PM
Ivy Woods Care Center

Course # 6
08/15 12:00 PM
Tri-County Extended Care

Course # 2
08/17 12:00 PM
Fort Hamilton Hospital

Course # 5
8/22 12:00 PM
Chateau at Mountain Crest

Course # 1
08/24 12:00 PM
St. Theresa

Course # 5
08/29 12:00 PM
Pristine Senior Living- Norwood Towers

Columbus Courses:

Course # 7
08/04 12:30 PM
Westminster-Thurber Retirement Community

Course # 10
08/16 12:00 PM
Eastland Care Center

Course # 3
08/22 12:00 PM
St. Ann's Rehab

Dayton Courses:

Course # 2
08/10 12:00 PM
Kettering Rehab

Course # 5 
08/17 12:00 PM
Wilson Memorial Hospital

Optimus Prosthetics, Dayton
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Dayton, Ohio 45414
(937) 454-1900

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3132 Olentangy River Road
Columbus, Ohio 43202 
(614) 263-LIMB (5462)

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Cincinnati, OH 45212
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